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Fasting Capillary Glucose Useful in Screening for Gestational Diabetes

Women with gestational diabetes can be accurately identified by measuring fasting capillary glucose. There is no generally accepted screening test for gestational diabetes, the authors explain, and the diagnostic criteria continue to be debated.

Dr. Helena Fadl from Orebro University Hospital, Sweden and colleagues evaluated the diagnostic properties of fasting capillary glucose as a screening test for gestational diabetes in a low-risk population of Swedish women.

"In this study, we present gestational diabetes mellitus as the combined group of impaired glucose tolerance and diabetes mellitus," the team explains.

Of 3610 pregnant women tested, 55 (1.5%) were diagnosed with gestational diabetes, the authors report. Of these women, 43 (1.3%) were classified as having impaired glucose tolerance, and twelve (0.3%) had diabetes.

Sensitivity for diagnosing gestational diabetes ranged from 87% to 47% for fasting capillary glucose cutoff values between 72mg/dL and 90mg/dL (4.0 and 5.0 mmol/L,) the report indicates, with specificities ranging from 51% to 96% for the same cutoff values.

"In the present study," the researchers note, "fasting capillary glucose of 76mg/dL (4.2 mmol/L) or greater, comparable with 85mg/dL (4.7 mmol/L) plasma value, gives approximately the same sensitivity as reported for the 50-g glucose challenge test but lower specificity."

"In this Swedish, unselected, low-risk population," Dr. Fadl and colleagues conclude, fasting capillary glucose measurements "had high acceptance and could be used in clinical practice."

BJOG 2006;113:1067-1071. An International Journal of Obstetrics and Gynaecology.

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